Clinical manifestations and endocrine functions were evaluated in 17 children with suprasellar germinoma. Polyuria and growth retardation were the most common initial symptoms. Physical and neurological examinations revealed diabetes insipidus in 17, growth retardation in five, and visual disturbance in three of the patients. Assessment of hypothalamic-pituitary function before treatment revealed pituitary deficits in all patients involving growth hormone, thyroid-stimulating hormone, luteinizing hormone, follicle-stimulating hormone, and adrenocorticotropic hormone. These pituitary dysfunctions persisted after tumor remission due to radiation therapy. These results indicate that children with suprasellar germinoma need long-term hormone replacement therapy to prevent growth retardation, thyroid dysfunction, and delayed secondary sexual development.